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Montana rates for HCPCS 41870

Periodontal Mucosal Grafting

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$254.55 / $307.36 / $6,300.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$343.35 / $343.35 / $343.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$486.37 / $486.37 / $486.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.70 / $429.92 / $833.74
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$311.08 / $415.11 / $574.30
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$301.24 / $445.51 / $642.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$413.10 / $517.44 / $613.91